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37 _,CITY OF LA OUINTA
HOME OCCUPATION PERMIT
APPLICATION
10-105 cell. E.t.se
F.O. Box 1504
L• OulataAA. 92253
(610) $ts - lilt 46
564-2246 PLANNING DIVISION , �� 557
ead each condition listed on the reverside side of this form to see It
the proposed y can co with the City's Home Occupation
Regulatio . $35.00 fee
TYPE OR PRINT IN INK
APPLICANT'S NAME Q-,% F . Card 0 F PHONE shy -7
]PROPERTY OWNER Qov-6. Card .P PHONE S6Y- S97 /
PROPERTY ADDRESS q8965 Ave. erk%-nain
)Street) 9 gas 3 FO &x 1 t77
(City) (State) (Zip)
Type of residence (Single, Multiple, mobile home, etc.) S I't) �e
-r' r
Type of business I ra,%por 4 W esr Goes
Brief description of how the business will operate P40ne. W01 be
-
4 -t
;::s2wcr.d a.t ,O.wa will Jot j2ojtd er Caikolor Cat�lko,.e P -a pftretf-ca
Cors &rj- K t.ot tet odri u 9rs ho►s¢s , No cl" address
Number of persons involved in business I at %ycse a it cors
List names of persons employed 2S horovi C4rdi-V� of d ouse i,
Square footage of usable floor area in
house (exclude garage) Validation Stamp
79
Location and square footage of area of to to
` a.0 i. i TC) 11-17-88 i0
iC.1 �H iiTAL i 35.00
business activity in home (example:
bedrooms; 125 square feet)
_a k I I = I/ 1 50 P60.
Description of machinery, equipment, and supplies being used in the
business operation P Wow
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
APPLICAOT SIGNATURE DATE
If Applicant is other than property owner, authorisation of owner or agent
required.
OWNER OR AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for denying
your Home Occupation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
t t t � • I t f f • • * t
APPROVED Initials
CONDITIONS ATTACHED
DENIED Initials
LQHOMOCC.PRT
Date
Date